Foreign bodies in the tracheobronchial tree: clinical and radiological analysis of cases over a 50-year period.

Objective: To analyze cases of foreign body (FB) aspiration in the last 50 years, describing clinical presentations, radiological characteristics, extraction methods, complications, and surgical interventions. Methods: A documentary study was conducted by reviewing the medical records of patients diagnosed with FB aspiration in the 1976-2025 period at the São Paulo State University School of Medicine Hospital, located in the city of Botucatu, Brazil. Results: A total of 240 patients were analyzed; 60% were male, with a median age of 3 years (IQR, 1-10 years). A history consistent with FB aspiration was present in 82%. Radiological findings included atelectasis, in 30.7%; radiopaque FBs, in 22.6%; normal chest X-rays, in 19.2%; and hyperinflation, in 18.3%. Rigid bronchoscopy was performed in 92% of the patients, flexible bronchoscopy was performed in 3.5%, and laryngoscopy was performed in 1.3%. In 3%, the FB was spontaneously expelled. The sensitivity of clinical and radiological findings was 83% and 83.2%, respectively. Ten patients required surgery, and 79 developed complications. Conclusions: Any suspected FB aspiration should be investigated, even when clinical and radiological findings are negative. Prolonged FB retention in the bronchial tree can lead to severe and irreversible complications. Most FBs are radiolucent, predominantly consisting of grains or seeds. Endoscopic removal remains the mainstay of treatment, with only a minority of cases requiring surgery. Early intervention is essential to prevent complications.